The shortest path is through your brain. Here are the tools you need.

"I was doing really well until..." As a doctor who counsels women trying to lose weight, I've heard this too many times. An upset patient settles into the overstuffed armchair across from my desk, and utters her tale of defeat.

You've probably said those words yourself, dozens of times. You're doing great, eating right, working out regularly, and something happens. You hurt your back and find it difficult to train. Maybe life just gets crazy and suddenly you're missing workouts and turning to food for comfort. The hell with minimeals and lean protein. What you need is a pile of cookies.

I sympathize—I've had my share of those days. But life happens. I have no doubt that you're a master at helping the people you care about get through tough times. But when things get funky in your life, do you give yourself the same treatment?

The following 10 steps are all about turning that feminine impulse to nurture inward and becoming your own best caregiver, regardless of the obstacles life places in your weight loss path. These principles will help you stay on track, no matter what life throws at you.

1. Pledge to Change

You've had it. You're tired of feeling like crud every day, and you're determined to get in shape, mentally and physically.

Hold on. You may be champing at the bit to overhaul your weight loss program, but if your positive changes are to be permanent, you need to recognize the adversity you'll face. I want you to put your intentions in writing and acknowledge the difficult times to come. On the best stationery you can find—no scrap paper—write out and complete the following contract.

I, ______________________ , commit to starting my weight loss program on ___________ (date). I believe that I can accept and complete my challenge to the best of my ability.

I realize this is work and accept the self-care price I must pay to achieve my mental and physical transformation.

I commit to keeping a daily journal that tracks my progress and forgives my slipups.

I will practice these 10 principles to help myself stay the course.

I will expect and adapt to adversity and see tough times as learning opportunities.

I will strive to take action and not to ruminate, bitch, moan, or whine.

I will be self-assertive and fight for the right to take care of myself.

I will acknowledge and reward myself for my achievements along the way.

You will do battle with your inner demons that try to pull you back into your familiar, self-destructive ways. But in the end, you'll win. Every time you embrace this challenge, you're one step closer to the best woman you can be.[pagebreak]

2. Find Your Motivation

When I was in medical school, I was taught that the greatest motivation to change an unhealthy lifestyle is the desire to prevent or treat a disease. But I have a vivid memory of a woman I sent packing after a coronary bypass, who told me she couldn't wait to load up on her favorite fast food and light a cigarette to celebrate.

Often, getting healthy isn't enough of a weight loss motivation. That's why I'm asking you to create a Motivational Target—like an archery target with inner and outer rings. The outer rings include the reasons you feel obligated to make a change, such as your health, and the inner rings are the deeply personal, maybe even hidden reasons that make you want to change. Here's how to do it:

Sit down with a piece of blank white paper. Draw an archery target—at least four rings and a bull's-eye. Ask yourself one question: Why do I want to change my body? Write down the first three answers that come to mind.

Chances are, they represent your Global Motivations: I want to change because I want to be healthier. I want to change because I'll die if I don't. Distill your answers into simple phrases and write them in the outermost ring.

Now go deeper. Ask again: Why do I want to change? Look for answers that stop you in your tracks. They might be serious or humorous. Write out the first three you think of and turn each into a key phrase.

These are your Target Motivations, and you need to anchor them with a Mantra that will conjure up its power when you need it most. It should be simple, contain a powerful visual image if possible, and smack you in the head like an invisible two-by-four so it will knock you out of your "I gotta eat" trance. It should also contain the phrases "run from" and "run to." Here's an example of how you might come up with a Mantra:

Say your Target Motivation is to be happy, fit, and free, living life to the fullest. But right now, there's a package of Oreos screaming at you. So what's the consequence of giving in? How about this: You're standing in the hot summer sun, dressed in dark, shapeless clothing that feels like a shroud. You're sweating as you watch others jog in shorts, bike in colorful clothes, and enjoy life. So "sweaty shroud" is what you run from. What do you want to run to? After some thought, you might conjure up a vision of yourself on a bike, clad in a pair of clingy biking shorts, riding up a long hill on a country road. You look and feel fit and free. You're joyful, happy, loving life. Okay. You've got it.

Motivation Mantra: Run from sweaty shroud; run to bike ride on country road, feeling joyful and free.

Repeat this process for each of the inner rings. You'll end up with at least three Target Motivations, any one of which can function as your bull's-eye.[pagebreak]

3. Learn to Let Joy In

When I meet a patient, one of the first questions I ask is, "What in your life gives you joy?" Women often say, "My partner" or "My kids." My response is, "Aside from your family, what gives you joy?" Too often, the reply is a blank stare.

Caring for a family is one aspect of what makes you whole. You must find what else brings you joy, whether that's returning to school, writing, growing a garden, or cooking gourmet meals.

One way to start along the path to joy is to stop each time you're confronted with a demand on your time and ask yourself this question: "Will this thing, event, or person bring me joy?" If the answer is, "Absolutely," congratulations—you've discovered what you need. If you answer, "I don't know," then give it a try. You'll know soon enough. But if the answer is, "No," why would you let it into your life? If you can't avoid it, limit the time you devote to it.

You may have to put in some work to find joy. At the age of 40, I laced up my sneakers and gave running a try. Now I'm in training for my third marathon.

4. Whine But Get the Job Done

Next to the armchair that my patients use during their appointments sits a ceramic jar labeled "Dr. Peeke's Early Retirement Fund." When a patient starts in with the negative self-comments, she has to put $1 into the jar. At the rate some of my patients are going, I'll be playing golf 24-7 in no time.

Listen to yourself: "I'm stupid, I'm fat, I'm ugly, I'm a failure, my legs are too short..." I call this a Rumination Rut. The dictionary definition of ruminate is "to go over in the mind repeatedly." The next definition is "to chew repeatedly for an extended period." Let's see, stewing and chewing in response to stress—boy, did Webster get that right. This leaves you vulnerable to BMW—bitching, moaning, and whining—about your body, your willpower, your behind, your this, your that. The biggest source of BMW-ing is refusing to accept that weight loss transformation takes mental and physical sweat, intensity, mindfulness, and focus—all the things, by the way, that you apply to your job, your kids, and your relationships.

Getting out of the rut is straightforward: Employ any distraction technique at your disposal. Get off the couch and go for a walk. Take the kids bowling or roller-skating. Clean out your closets. Do anything but let your brain hold your butt hostage.[pagebreak]

5. Forget Perfection, Embrace Progress

Some women have a huge problem with this principle because all their lives, they've tried to be perfect—perfect wife, perfect mother, perfect employee, perfect friend. Is this your story, too? Look, no woman—no human—diets and trains perfectly day after day, so striving for perfection is a prescription for guilt. It eats away at the positive energy you need for making progress.

"Progress, not perfection" means that if you work hard and keep your focus 80% of the time, you're doing great. The other 20% of the time, you get to be human—fallible. Did you miss your workout today? No worries. You'll regroup and bounce back tomorrow.

Here's where keeping a journal will come in handy. Reflect on your day and write down at least three things that you did well and that helped you move forward. This gives you positive reinforcement and helps you build momentum because you're giving yourself credit where credit is due.

6. Control Stress, Find Peace

For most women, stress is a constant companion. It's there as they speed to work, pay the bills, or pick up a gallon of milk at 10:30 at night so everyone can have cereal the next morning. In one survey on stress conducted by the National Women's Health Resource Center, nearly 93% of the 681 people surveyed described the level of stress in their daily lives as moderate or higher. Fewer than half said they always felt capable of coping with it.

There are two main categories of stress in a woman's life. Everyday stress is the kind we expect and should be able to manage: the daily commute, the parking ticket, the computer malfunction; stresses from major milestones, like getting married or having a child, are tougher but also manageable.

Toxic stress, on the other hand, grinds you down day after day, year after year. It erodes your immune system and makes PMS and perimenopause a living hell. It also ramps up your appetite for comfort foods and can pack on pounds of fat deep inside your tummy, expanding your girth and making you more vulnerable to heart disease, diabetes, and cancer. Work is a huge source of toxic stress for women—perhaps the biggest. In one study of more than 21,000 nurses (the ultimate caretakers), Harvard University researchers concluded that on-the-job stress weakens a woman's health and weight loss as much as smoking or a sedentary lifestyle. My Stress Rx signs will help. You can make these signs and photocopy several. In really big, colorful letters, write:

STOP!The Answer Is NOT in Here.

Tape these to your fridge, kitchen cabinets, pantry—even on the vending machine at work, if you dare. When you confront this sign, close your eyes for a second. Take a deep breath and say, "The answer is not in this fridge/vending machine/pantry."

Your second sign should read:

The Answer Is Here.

Tape this to your workout bag or your dumbbells at home, your bath salts, your favorite relaxing CD, your treadmill, your favorite herbal tea, or your phone. After stopping at the first sign, walk quickly toward this one. This is what will truly soothe you. Sip a mug of your favorite tea. Be with your feelings. Honor that new voice inside you. It's the voice of empowerment, and each time you withstand stress in a positive way, the voice will become louder and stronger.[pagebreak]

7. Give Yourself License to Chill

Buddha said, "We are what we think. With our thoughts, we make the world." If you're in a continual state of depression, anger, frustration, or fatigue, your world will feel pretty small and unfulfilling. That's why I want you to commit to practicing relaxation techniques.

Research supports meditation's positive effects on mood. What's more, it appears to literally change the minds of those who practice it. A study in the Journal of Psychosomatic Medicine revealed that brain scans of new meditators who were guided in meditation 3 hours a week for 8 weeks showed significant increases in activity in a part of the brain associated with positive emotion. What's more, the heightened activity persisted for at least 4 months after the experiment, when the study participants were scanned again.

Meditation, yoga, tai chi, progressive relaxation—it doesn't matter which you choose, as long as you like it and do it regularly. I recommend that you take a class, but if you can't, buy a book or video. Taking a class serves three purposes: You get correct instruction, meet other like-minded people, and automatically build some "me" time into your day.

If you want to experiment on your own, try walking meditation. It's just what it sounds like: combining a walk with quiet reflection. Don't think about a destination. Simply turn your full attention to the movements that make up the act of walking. Break it down to its basics. For example, as you lift each foot, silently say to yourself "lift." As you move your leg forward, say "move." Then say "step" as you place your foot on the ground. The more you focus on these movements, the calmer you'll feel. (For more ways to meditate, see Think You're Not The Mediation Type?)

8. Learn to Stay Calm in a Crisis

You must practice your self-care as best you can in the worst of times. The ability to regroup allows you to continue a healthy eating, weight loss, and activity plan no matter what the crisis. Your goal is to keep regrouping until you achieve a new plan that works for you.

Plan A is your life on schedule. You eat breakfast every day at 7 am, you walk on your lunch hour, you have your "me" time every night after 9, when you put the kids to bed. Plan A goes seamlessly about once a year. Relish the moment.

Plan B is your life on stress. You've been up all night with your youngest, so you're sleeping when you usually eat your egg-white omelet. You're under the gun at work, so the big report takes precedence over your walk. Your mom and sister are having another one of their interstate wars, so you've been on the phone with one or the other every night, instead of cozying up with a book. So how do you tend to your self-care? You go to Plan Me.

This is your fallback, the way to take care of your needs in the midst of chaos. To prepare this plan, write down what your healthy eating, weight loss and activity plan would look like on a low-stress day. That's Plan A. Now make a list of everything that could wreck that plan and rewrite it, devising ways to work around these problems. Here's a simple example: It's too cold to take your Plan A walk. Go to Plan Me—walking in the mall or on the health club's treadmill.

If you really get off track, Plan Me can be 3 days of withdrawal and regrouping to regain momentum. In those 3 days, you'll refocus on Plan A, practice it, and let it gel before diving in again.[pagebreak]

9. Fight for Your Self-care

I see women try to get their partners and family to help create time for their self-care. Meeting resistance, the women simply give up. Not anymore. You're learning to stand your ground and make it work. You realize you're not being selfish, you're just asking for balance.

Every successful company has a mission statement—a paragraph or two that states why it exists, whom it serves, and what it hopes to achieve. Knowing your mission teaches you to set boundaries, draw a line in the sand, and say, "This is my time, and I'm here to defend it." You're on your treadmill and the phone rings. That's why there's voice mail. The call can wait. Your self-care can't.

Write down no more than 10 sentences that describe what you want to accomplish in your life and what is important to you, both personally and professionally. You could focus on being the best spouse, mother, and daughter you can be. But don't forget to commit to honoring your intellectual, physical, and spiritual needs—and above all, your rights as an individual.

To cure a chronic case of "yes-itis," here's what to do the next time you're asked to do something that you can't or don't want to do:

1. Ask yourself, Will saying yes further my mission statement? For example, if you've already volunteered for countless PTA events in the past year, do you really need to take on another?

2. If the answer is no, say in a calm and caring tone, "I'm so sorry, but that doesn't work for me right now. Maybe next time." Wow. Saying this shows that you know what works for you. Now, once you've said it, stick to it. Stand up to anyone who tries to argue you down. Keep your refusal courteous but definite, short but sweet, and don't get into a debate.

10. Form a 911 Squad

Research shows that people trying to make healthy lifestyle and weight loss changes are more likely to succeed when they have a strong support network. With a minimum of effort, you can assemble your very own Estrogen Squad.

Call one or more members of your Estrogen Squad when you're about to do something self-destructive—like blow off your workout or embark on a binge. Choose one or two people you most depend on, with whom you feel comfortable sharing your deepest feelings—your mother or sister, a special aunt, maybe even a teenage daughter. Then choose the one or two friends who have given you the most support and encouragement, or who might like to join your weight loss efforts. Consider including a personal trainer, a therapist, or your family doctor, if he or she is caring and supportive of your weight loss goals.

Those in your squad should be kind, of course, and willing to reply to your calls, e-mails, and more. They should also be able to look you straight in the face and tell you that dress doesn't work for you, or that you're making everyone nuts with your endless BMW-ing. A sassy sense of humor never hurts, either.

A woman's efforts are most successful when supported by her assertive, witty, loving, and nurturing sisters. Armed with her Estrogen Squad, a woman will see her quest for mental and physical transformation become a reality.

One of my favorite maxims is "In the midst of difficulty lies opportunity." I don't see mistakes—I see opportunities to learn. Open your heart to the lessons. If you view challenging life events as opportunities to recommit to your self-care rather than as overwhelming obstacles, you will overcome them. If you should lose your footing along the way, review these principles. You know the answers are here and inside of you.